Dexamethasone, High-Dose Cytarabine, and Cisplatin in Combination with Rituximab as Salvage Treatment for Patients with Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma

Mey, Ulrich; Orlopp, K.; Flieger, Dimitri; Strehl, John; Ho, Anthony D.; Hensel, Manfred; Bopp, Cordula; Gorschlüter, Marcus; Wilhelm, Martin; Birkmann, Josef; Kaiser, Ulrich; Neubauer, Andreas; Florschütz, Axel; Rabe, Christian; Hahn, Christian; Glasmacher, Axel; Schmidt‐Wolf, Ingo G.H.

doi:10.1080/07357900600814490

Cited by 52 publications

(28 citation statements)

References 30 publications

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“…The most significant adverse prognostic factors for response in both the whole series and the R+ group were the presence of bulky disease, primary refractory disease, an aaIPI higher than 1 at the time of R-ESHAP, as well as the administration of fewer than three cycles of R-ESHAP. Moreover, the presence of primary refractory disease and high-risk aaIPI at the time of R-ESHAP were also independent adverse prognostic factors for survival, in accordance with reports from other authors, 9,13,14,[23][24][25][26] but in contrast to the data published by Kewalramani et al, 13 who observed that the addition of rituximab to the ICE regimen seemed to overcome the adverse effects of an unfavorable IPI score. The dismal outcome of patients with primary refractory disease or with an unfavorable aaIPI at the time of relapse underlines the need for the evaluation of alternative treatments.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Ncontrasting

confidence: 57%

R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study

Martı́n¹,

Conde²,

Arnán³

et al. 2008

Haematologica

159

118

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Section: © F E R R a T A S T O R T I F O U N D A T I O Ncontrasting

confidence: 57%

R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study

Martı́n¹,

Conde²,

Arnán³

et al. 2008

Haematologica

159

118

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“…A recent study reported a 92% CR rate in 24 patients with previously untreated mantle cell NHL with RDHAP [20]. Mey et al [21] performed a trial of RDHAP that focused only on patients with relapsed aggressive NHL and patients could not have received prior rituximab. The RDHAP regimen differed from this trial in that the rituximab was given d1 of each of a planned four cycles.…”

Section: Discussionmentioning

confidence: 99%

Salvage chemotherapy with rituximab DHAP for relapsed non-Hodgkin lymphoma: A phase II trial in the North Central Cancer Treatment Group

Witzig

Geyer

Kurtin

et al. 2008

Leukemia & Lymphoma

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The aim of this study was to learn the toxicity and efficacy of adding 4 doses of rituximab to a standard platinum-based salvage regimen for relapsed CD20+ B-cell non-Hodgkin lymphoma. Patients were treated with rituximab 375 mg/m 2 days 1,8,15, 22 (cycle 1 only); cisplatin 100 mg/ m 2 over 24 h on day 3, cytosine arabinoside 2 g/m 2 IV every 12 h × two doses on day 4, dexamethasone 40 mg PO/IV days 3-6, and G-CSF days 5-14. The ORR was 82% (47/57) with 33% (19/57) complete remissions and 49% (28/57) partial remissions. The duration of response (DR) for the 47 responders was 10.5 months (95% CI: 5.3-16.8). The median time to progression (TTP) was 10.3 months (95% CI: 5.3-14.0), the median event-free survival (EFS) was 5.3 months (95% CI: 3.9-11.0), and the median overall survival was 30.5 months (95% CI: 17.8-60.6). We conclude that rituximab can be safely added to standard DHAP.

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“…30% (6/20) received etoposide in addition to CHOP (as CHOEP or EPOCH) [9,[23][24][25][26], with or without intrathecal chemotherapy. 5.0% (1/20) received CHOP alternating with DHAP (dexamethasone, high dose cytarabine, cisplatin) [28,29]. There were no significant differences in primary systemic therapies received between the two groups (P 5 0.82, Table I).…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Autologous stem cell transplantation in first complete remission may not extend progression‐free survival in patients with peripheral T cell lymphomas

et al. 2016

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*Patients with peripheral T cell lymphomas (PTCL) generally have a poor prognosis when treated with conventional chemotherapy. Consolidation with autologous stem cell transplantation (ASCT) has been reported to improve progression-free survival. However, these studies have not compared consolidative ASCT with active observation in patients with PTCL achieving first complete remission (CR1) following induction chemotherapy. We conducted a retrospective analysis of PTCL patients treated at the University of Pennsylvania between 1/1/2007 and 12/31/2014. Patients with cutaneous T cell lymphoma, concurrent B cell lymphomas, and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-positive ALCL) were excluded from the study. We compared progression-free survival for patients who underwent ASCT in CR1 following CHOP-like induction regimens and patients who underwent active observation during CR1. 48 patients met all inclusion and exclusion criteria and underwent either active observation (28 patients) or consolidative ASCT (20 patients) in CR1. The 1-year cumulative incidence of relapse in the observation and ASCT groups was 50% (95% confidence interval [CI]: 30-67%) and 46% (95% CI: 23-67%), respectively (P 5 0.55). Median progression-free survival in the observation and ASCT groups was 15.8 and 12.8 months, respectively (log rank, P 5 0.79). Estimated 3-year progression-free survival in the observation and ASCT groups was 37 and 41%, respectively. In conclusion, for PTCL patients achieving CR1 following CHOP-like induction chemotherapy, ASCT does not appear to improve progression-free survival compared to active observation. This finding should be confirmed in a larger, prospective study. Am. J. Hematol. 91:672-676, 2016. V C 2016 Wiley Periodicals, Inc. IntroductionPeripheral T cell lymphomas (PTCL) are a group of heterogeneous mature T cell neoplasms. For a variety of reasons, prognosis is poor when treated with conventional chemotherapeutic agents. There is currently no consensus on the optimal frontline treatment strategy for PTCL due in part to the lack of data from randomized controlled trials. Based on extrapolated data from studies in aggressive B cell non-Hodgkin lymphomas [1][2][3], the vast majority of patients with PTCL will receive CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)-like induction chemotherapy. Although complete remission (CR) rates of 50-70% have been reported with CHOP-like chemotherapy [4][5][6][7][8][9], relapse is common. Notably, despite significantly higher rates of initial response, 5-year event-free survival rates as low as 33% have been reported [10].Consolidative autologous stem cell transplantation (ASCT) is frequently offered to PTCL patients in first complete remission (CR1) based on data from prospective studies showing improved overall survival (OS) and progression-free survival (PFS) when compared with historical controls [11,12]. However, since most studies of ASCT in PTCL include patients who achieve a partial response (PR) to standard chem...

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Dexamethasone, High-Dose Cytarabine, and Cisplatin in Combination with Rituximab as Salvage Treatment for Patients with Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma

Cited by 52 publications

References 30 publications

R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study

R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study

Salvage chemotherapy with rituximab DHAP for relapsed non-Hodgkin lymphoma: A phase II trial in the North Central Cancer Treatment Group

Autologous stem cell transplantation in first complete remission may not extend progression‐free survival in patients with peripheral T cell lymphomas

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